Step One

It is our policy to comply fully with all federal, state, and local equal employment laws. This organization provides equal employment and advancement opportunities for all persons regardless of race, creed, sex, national origin, age, religion, disability, martial status, sexual, orientation or any other classification protected by law.

Position Applied For*

Last Name*

First Name*

Middle Initial

Other Names You Have Used

Address*

City*

State*

Zip Code*

Contact Phone Number*

Are You At Least 18 Years Old?*

Yes

No

Email Address*

Salary Requirements*

How did you learn about this position?*

Date Available

Have you ever been employed by this organization?*

Yes

No

When?

Department

Supervisor

Reason for Leaving

Have you ever been convicted of a felony? A conviction will not necessarily disqualify an applicant from employment.

If yes, give location, date, charge, and disposition of case(s) on a separate page.

Yes

No

Do you have a valid driver's license?*

If applying for a position which requires driving a vehicle, please provide this information.

Yes

No

Can you, if hired, submit verification of your legal right to work in the United States?*

Yes

No

If you have served in the U.S. Military, please provide the following information:

Employment History

This portion of the application must include a minimum of ten years of work history and must be completed even if supplemented by a resume. List your most recent employer including U.S.Military service and unpaid or volunteer work. Base salary does not include overtime, bonuses or commissions.

From (mo/yr)*

To (mo/yr)*

Total years*

Total months*

Your position*

Employer*

Your supervisor*

Address*

Phone*

Type of business*

Reason for leaving*

Starting salary

Final salary

Rate

Monthly

Weekly

Hourly

Other compensation, bonuses

Brief description of your duties and responsibilities*

From (mo/yr)

To (mo/yr)

Total years

Total months

Your position

Employer

Your supervisor

Address

Phone

Type of business

Reason for leaving

Starting salary

Final salary

Rate

Monthly

Weekly

Hourly

Other compensation, bonuses

Brief description of your duties and responsibilities

From (mo/yr)

To (mo/yr)

Total years

Total months

Your position

Employer

Your supervisor

Address

Phone

Type of business

Reason for leaving

Starting salary

Final salary

Rate

Monthly

Weekly

Hourly

Other compensation, bonuses

Brief description of your duties and responsibilities

From (mo/yr)

To (mo/yr)

Total years

Total months

Your position

Employer

Your supervisor

Address

Phone

Type of business

Reason for leaving

Starting salary

Final salary

Rate

Monthly

Weekly

Hourly

Other compensation, bonuses

Brief description of your duties and responsibilities

From (mo/yr)

To (mo/yr)

Total years

Total months

Your position

Employer

Your supervisor

Address

Phone

Type of business

Reason for leaving

Starting salary

Final salary

Rate

Monthly

Weekly

Hourly

Other compensation, bonuses

Brief description of your duties and responsibilities

Explanation of Interruptions in Employment History

Please use this space to explain employment history interruptions since high school that do not pertain to pregnancy, child care, disability, or any other protected activity.

Resume and Cover Letter Submissions

Equal Employment Opportunity Questionnaire

The City of Spring Hill would appreciate your assistance in completing this brief questionnaire. The answers will be used solely for the purpose of evaluating and reporting the effectiveness of our recruiting and equal employment opportunity efforts. This form will be held separately from your application/resume and will not be used as a basis for any decisions regarding your employment.